Salutogenesis and the Sense of Coherence in Middle Adulthood

In this chapter, the authors focus on the transition from middle to late adulthood. The questions of when and how past transitions affect subsequent ageing is discussed. Whilst middle age was long considered undramatic, the authors state that it is increasingly gaining profile. They focus on a phase typically observed in the sixth decade of life, characterized by the initiation of the transition to de-professionalization and change of responsibilities within the family when crisis and chronic situations can lead to the need for help from health professionals.The authors deliberate on how a dialogue between middle-aged adults and professionals can contribute positively to the naming, modification, design and further development of health goals, linking physiological and unconscious processes to the theory of salutogenesis.Notably, the authors frame illness processes from the perspective of salutogenic resources, also discussing the benefits of crises experienced in middle adulthood.The authors’ novel ideas about a salutogenic perspective on life in middle adulthood will inspire researchers and practitioners to a more innovative approach to this large segment of society.

Primary Orthostatic Tremor in Adolescence

Tremor is an involuntary rhythmic muscle contraction, which causes a regular oscillation of a part of the body. Orthostatic tremor is a rare neurological movement disorder characterized by unsteadiness while standing that is relieved when sitting, walking, or lying down. Neurological examination of primary orthostatic tremor is reported to be normal. The pathophysiological mechanism of this condition is not entirely unknown. Symptoms usually start in the sixth decade. Clonazepam is widely used as a first-line medication in the treatment. A 14-year-old girl patient was admitted due to tremor activated on standing, absent while seated or lying, and improved by walking or leaning. Her brain magnetic resonance imaging and laboratory workup were normal. Tremor completely disappeared with clonazepam in 10 days. I report a case of primary orthostatic tremor in adolescence.

Sudan low changes affecting rainy days in southwestern Iran during the six decades (1957–2019)

The present study evaluated the dynamic changes in Sudan low systems during six decades (1957–2019), which were classified based on solar cycles. Rainfall days were extracted in January using data from 42 synoptic stations in the south and southwest regions of Iran. Then, the rainy days due to the Sudan low system were separated from the precipitation of the other atmospheric systems using the visual analysis of the maps. The synoptic analysis indicated that the sea level pressure has been decreasing at all sampling stations from the first to the sixth decade. Furthermore, decreasing elevation to −80 m (negative anomaly) in the 500 hPa level atmosphere from the first decade to the sixth decade, indicated further atmospheric instability and more strengthening of the Sudan low compared to previous decades. The contribution of advection moisture to the area increased within the region at 700 hPa. This implies that the role of the transferred moisture from the intertropical convergence zone is increasing in the systems transferred from Sudan and in the study area. In general, the share of Sudan low precipitation is increasing in the south and southwest regions of Iran. This result is a positive effect of the climate change on the study area.

Fully Ossified Thyroid Cartilage Found among the Skeletal Remains of A 21-Year-Old Slavic Soldier: Interpretation of a Case

The degree of ossification of the thyroid cartilage in anthropological studies is related to other methods of determining the age of a skeleton. The endochondral ossification process begins at the age of approximately 15–20 years and is generally completed in the fifth or sixth decade of life. In the present case, early and complete mineralization of the thyroid cartilage of a skeleton belonging to a 21-year-old young soldier who died in 1946 was observed. Ossified thyroid cartilage at a very young age is rare and may be associated with specific symptoms, such as compression due to trauma, or may also be related to hormonal dysfunction and various diseases that may cause early mineralization. A macroscopic morphological evaluation and radiographic examination of the thyroid cartilage were performed and a decalcification test was applied to a sample taken from the thyroid cartilage to confirm that the structure was indeed mineralized. There is nothing to exclude that this is simply a physiological anatomical variation. Knowledge of this rare anatomical abnormality at a young age would be useful for the diagnosis of various pathological conditions.

Robotic, totally endoscopic excision of mitral valve papillary fibroelastoma

Papillary fibroelastoma is a rare, benign tumor that affects males more frequently than females and that tends to be diagnosed during the fifth or sixth decade of life. It tends to arise on cardiac valves, with the aortic valve being the most frequent location followed by the mitral valve, the tricuspid valve, and the pulmonary valve. We present the case of a robotic-assisted, totally endoscopic excision of a mitral valve papillary fibroelastoma.

Stenosing flexor tenosynovitis of the hand (trigger finger)

Trigger finger is the second cause of consultation with the hand surgeon. In 2009, Kerrigan published a strategy for the treatment of this pathology, which consists of two infiltrations with corticosteroids in the sheath of the flexor tendons at the level of the A1 pulley, followed by percutaneous or open surgical release, following the algorithm described by the author. 140 files that met the inclusion criteria were analyzed. It was found that the female gender is the most frequently affected during the sixth decade of life in 46%. The most frequently affected finger is the third, affects the right hand in 44% and both hands in 29%. 91% of the patients received a first infiltration and only 31% of these received a second infiltration. The surgical procedure was decided in 33% of the patients. The longest follow-up was 180 months and the shortest was 3 months with 100% of asymptomatic patients. The algorithm proposed by Kerrigan in the treatment of this pathology is a good strategy that has a high success rate without having to perform a surgical procedure as the first treatment option.

A Comprehensive Update of the Incidence and Demographics of Laryngoceles in Adults

Objective: To provide updated data on the incidence, types, and demographics of laryngoceles in the adult population. Methods: We searched the medical archives of our institute for computed tomography (CT) studies acquired between January 1, 2007 and December 31, 2017 in which the term “laryngocele” appeared in the radiology reports. Two of the authors reviewed relevant images for the presence, type, distribution, and laterality of true laryngoceles. Demographic and clinical data were extracted from medical records and the incidence was calculated. Results: Laryngoceles were detected in 53 out of the 79 893 patients with relevant CT data, which equates to an incidence of 151 per 2.5 million (0.06:1000) patients per year. The male:female ratio was 3:1, average age was 60 (±18) years, and incidence peaked among patients in the sixth decade of life. Nine patients (17%) had known laryngeal cancer; however, the majority of the cohort did not have follow up clinic visits. Conclusion: Our study demonstrates that the incidence of laryngoceles is much greater than previously reported. In most cases, the diagnosis of a laryngocele was an incidental radiological finding. Male gender predilection and age at presentation are in agreement with previous reports. Association of laryngoceles with laryngeal cancer could not be calculated due to low rates of follow ups. Level of Evidence: 3.

Parkinson's disease: Certain features of pathology, genetics, and pathogenesis

Parkinson disease (PD) is the second-most common and complex neurodegenerative disorders in humans, characterized by motor symptoms such as tremor, rigidity, bradykinesia, and non-motor symptoms such as insomnia, constipation, anxiety, depression and fatigue. Up to now, the diagnosis of PD has been mainly based on clinical symptoms with motor features being the mainstay and this limits the possibility of early detection. PD is usually diagnosis after the sixth decade of life, however about 5–10% of patients who develop the disease before the age of 50 are early-onset PD. The rapid development of genetic studies and their application may induce the early diagnosis of PD in the near future, especially for the early-onset PD. A few mechanisms have been implicated in PD pathogenesis, with α-synuclein aggregation central to the development of the disease. Multiple other processes are thought to be involved, with several studies suggesting that abnormal protein clearance, mitochondrial dysfunction, and neuroinflammation play a role in the onset and progression of PD. There are many PD patients in Vietnam, however, the studies are mainly based on clinical symtom descriptions. Given the aging of the population, the prevalence of PD is to increase dramatically, which would lead to increased urgency for the need to identify improved methods in diagnosis and treatment this disease.

THOMAS ADÈS AT 50: REPRESENTATIONS ON THE STAGE AND ON THE PAGE

On the evidence of the last year alone, Thomas Adès's international profile, as well as his productivity, remains undiminished as he enters his sixth decade. In a concert on 6 March 2021 to mark his fiftieth birthday, he conducted Kirill Gerstein and the London Symphony Orchestra in a performance of his In Seven Days and Sibelius's Sixth Symphony. Because lockdown restrictions in response to Covid-19 were still in force, the celebratory nature of the concert was necessarily muted – given behind closed doors, the players distanced – and only later uploaded to YouTube.

Granular Cell Tumor of the Tongue: A Rare Case Presentation of a 14 Years Old Girl

Granular cell tumor or Abrikossoff ’s tumor is an infrequent tumor that can arise in most organs, and especially in the ENT area. It is a usually benign neoplasm, that can lead to a misdiagnose of malignancy. It affects both sex, between the fourth and the sixth decade. We present in this report a case of a 14 years old girl with a slowly growing lesion on the right lateral border of the mobile tongue. The biopsy showed a proliferation of large cells with a granular cytoplasm that expressed two immunohistochemistry markers: CD68 and S100 antibodies. Surgical resection was completed with a one centimeter margin.The rare issue about this case is the age of presentation: the age of the patient is 14, whereas this tumor usually affects adult patients.